The Development of Caring for Acute Critically Ill Patients at Emergency Department In Sawanpracharak Hospital

Abstract

Abstract

The research and development are developed and study the results of the system development for acute care critically ill patients in the Emergency Department at Sawanpracharak Hospital. The study conducted during January 2021 – September 2021. The sample of the group are 1) 23 Registered Nurses 2) Acute Critically Patients which separate into pre and post study, 78 per group.

This study divided into 4 phase which are:

1. 
   

   Study and Analysis of acute critical patients in emergency department.

   
   


2. 
   

   Development of acute care system for critically ill patients.

   
   


3. 
   

   Implementation of the developed acute critical care system.

   
   


4. 
   

   Evaluation period of the study.

   
   

Tools included Knowledge and Skills assessment for acute critical care patients, Questionnaire on opinions of registered nurses on practice guidelines, and Satisfaction assessment of registered nurses towards development. Qualitative data were analyzed by content analysis. Quantitative data were analyzed by frequency distribution, mean, standard deviation, T-Test, and Mann Whitney U test.

The results of the study were divided into 2 parts:

1. 
   

   The acute care system for critically ill patients: Divided into 3 areas:

   
   
   • 
     

     1.1 Care standard area: Practice guidelines for taking care of acute critically ill patients.

     
     
   
   
   • 
     

     1.2 Staff area: Training on Nursing diagnoses, Nursing notes writing, and Practical guidelines.

     
     
   
   
   • 
     

     1.3 Management area: Preparing electronic records and setting up a dedicated critical care team.

     
     
   
   


2. 
   

   System results: Registered nurses had a higher average knowledge and skills in caring for acute critically ill patients than before training ($p < .01$). The mean time spent in the emergency department of the post-development group was 70.92 minutes ($S.D. = 36.96$), less than the pre-development group with a mean of 80.71 minutes ($S.D. = 48.76$). The mean waiting time to see a doctor in the post-development group was 1.40 minutes ($S.D. = 2.52$), less than the pre-development group with a mean of 4.01 minutes ($S.D. = 4.93$) at a statistically significant level of $< .01$. The satisfaction of registered nurses on development was 4.73 ($S.D. = .32$) out of a full score of 5.